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zaterdag 18 november 2017

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HSE Biocides e-Bulletin 17th November 2017

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EU Biocides Regulation 528/2012 (EU BPR) – Update to ECHA Biocides Guidance available

The European Chemicals Agency (ECHA) have published an update to the Guidance on the BPR: Volume III Human Health, Assessment and Evaluation (Parts B+C) to add a new section (Section 5) concerning Estimating Dietary Risk from Transfer of Biocidal Active Substances into Foods for Non-professional Uses.  Please see the European Chemicals Agency (ECHA) website for further details.



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The Lancet: [Articles] Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating po...

[Articles] Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (PATH): a randomised, double-blind, placebo-controlled, phase 3 trial
This study, which is to our knowledge, the largest trial of CIDP to date and the first to study two administrations of immunoglobulins and two doses, showed that both doses of SCIg IgPro20 were efficacious and well tolerated, suggesting that SCIg can be used as a maintenance treatment for CIDP.
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[Comment] Balancing ethics and care in disorders of consciousness
Neuromodulatory interventions that rely on the premise that stimulation activates or promotes brain circuit signals are being applied to a wide range of therapeutic targets in neurological and psychiatric disorders. The numbers of patients with whom these interventions are being tested, the range of approaches, and the variety of methods are all on the rise. Paralleling these trends are the increasing numbers of countries doing clinical trials, and the coverage of them in the press.1
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[In Context] The fantastic legacy of Terry Pratchett
Terry Pratchett, the author who died in 2015, was perhaps best known for his seminal Discworld novels: fantasies set on a flat disc of a world, held aloft by gargantuan elephants, on the back of a giant turtle swimming through space. Silly? Perhaps, but also utterly, utterly brilliant.
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[Rapid Review] Novel genes associated with amyotrophic lateral sclerosis: diagnostic and clinical implications
The disease course of amyotrophic lateral sclerosis (ALS) is rapid and, because its pathophysiology is unclear, few effective treatments are available. Genetic research aims to understand the underlying mechanisms of ALS and identify potential therapeutic targets. The first gene associated with ALS was SOD1, identified in 1993 and, by early 2014, more than 20 genes had been identified as causative of, or highly associated with, ALS. These genetic discoveries have identified key disease pathways that are therapeutically testable and could potentially lead to the development of better treatments for people with ALS.
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[In Context] Prescribing sleep for better health
It was a dark, autumnal, Monday evening, and for many of the audience at the Royal Institution of Great Britain (London, UK), the benefits of any extra sleep over the weekend probably felt all but over after the first day back at work. Rather than opting for an early night, however, we gathered to listen to a public lecture by Matthew Walker (Professor of Neuroscience and Psychology, University of California, Berkeley, CA, USA), entitled Why we sleep. As Director of the Center for Human Sleep Science, Walker's research aim is to uncover the effects of sleep in health and disease, but he is also active in science communication: giving talks and contributing to television and radio, and having published a book in October, 2017, with the same title as the lecture.
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The Lancet: [Comment] Tribendimidine: an alternative to praziquantel to treat human liver fluke infection?

[Comment] Tribendimidine: an alternative to praziquantel to treat human liver fluke infection?
Opisthorchis viverrini is a major foodborne trematode infection endemic to Greater Mekong subregion (GMS) countries, particularly Thailand, Laos, Cambodia, and Vietnam, with more than 10 million people in those countries infected.1 The parasite induces several hepatobiliary diseases, including cholangiocarcinoma.2 To date, the only drug of choice for the treatment of liver fluke infections has been praziquantel. Therefore, identification of new drugs to avoid development of mutations conferring resistance to praziquantel in the future is crucial.
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[Articles] Effect of HIV-1 low-level viraemia during antiretroviral therapy on treatment outcomes in WHO-guided South African treatment programmes: a multicentre cohort study
In this large cohort, low-level viraemia occurred frequently and increased the risk of virological failure and switch to second-line ART. Strategies for management of low-level viraemia need to be incorporated into WHO guidelines to meet UNAIDS-defined targets aimed at halting the global HIV epidemic.
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[Articles] Human papillomavirus types from infection to cancer in the anus, according to sex and HIV status: a systematic review and meta-analysis
HPV16 is by far the most carcinogenic HPV type in the anus, with enrichment of HPV16 even from high-grade lesions to anal cancer, both in individuals who are HIV negative and those who are HIV positive. Nevertheless, the fraction of anal cancer attributable to HPV16 is smaller in the HIV-positive population.
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[Comment] Stepping up HIV-1 low-level viraemia surveillance in South Africa
In The Lancet Infectious Diseases, Lucas Hermans and colleagues1 report the results of a large, multicentre cohort study investigating the incidence of low-level viraemia and its association with virological failure. Low-level viraemia was defined as HIV RNA viral load of 51–999 copies per mL. The investigators studied 70 930 HIV-infected adults from rural-urban areas of South Africa, 68% of whom were women, who were treated with first-line or second-line antiretroviral therapy (ART) regimens and monitored according to WHO guidelines.
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[Comment] The importance of HPV16 in anal cancer prevention
Like cervical cancer, anal cancer and its direct precursor lesion, high-grade anal intraepithelial neoplasia (AIN), are caused by persistent infections with human papillomaviruses (HPV).1 The natural history of HPV in cervical cancer has been comprehensively investigated. In the more than 40 HPV types infecting the anogenital tract, high-risk HPV-types and possible or probable high-risk types for the development of cervical cancer have been defined.2 Cervical cancer is preventable by regular screening.
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The Lancet: [Comment] Brentuximab vedotin for advanced Hodgkin's lymphoma

[Comment] Brentuximab vedotin for advanced Hodgkin's lymphoma
Brentuximab vedotin—through CD30-targeted delivery of monomethyl auristatin E into Hodgkin Reed-Sternberg cells—has transformed the management of patients with classical Hodgkin's lymphoma, through both its high frequency and long duration of complete remission.1 Since the initial approval of this agent, there has been high interest in its successful integration into earlier lines of management.2–4
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[Articles] Neratinib after trastuzumab-based adjuvant therapy in HER2-positive breast cancer (ExteNET): 5-year analysis of a randomised, double-blind, placebo-controlled, phase 3 trial
At the 5-year follow-up, 1 year of extended adjuvant therapy with neratinib, administered after chemotherapy and trastuzumab, significantly reduced the proportion of clinically relevant breast cancer relapses—ie, those that might lead to death, such as distant and locoregional relapses outside the preserved breast—without increasing the risk of long-term toxicity. An analysis of overall survival is planned after 248 events.
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[Comment] Extended adjuvant therapy in patients with HER2-positive breast cancer: some answers, even more questions
In 2006, the US Food and Drug Administration (FDA) approved trastuzumab for the treatment of patients with early-stage HER2-positive breast cancer. Clinical trials have confirmed that trastuzumab-based chemotherapy significantly reduces the risk of disease recurrence and improves survival.1,2 We know that the optimal duration of treatment is 1 year, and that trastuzumab is more efficacious when administered concomitantly with chemotherapy;3 however, efforts to further improve the outcomes of these patients with new drugs have been somewhat disappointing.
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[News] Defining precision medicine
On Nov 13, 2017, the European Society for Medical Oncology (ESMO) published the first edition of its precision medicine glossary. "Precision medicine is a new field, and terms have been developing without set definitions", explained co-author Fabrice André (Institut Gustave Roussy, Villejuif, France). "That [ambiguity] was starting to create some confusion, especially in the reporting of scientific papers, because the same word has different meanings depending on who is using it."
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[Articles] Extended adjuvant intermittent letrozole versus continuous letrozole in postmenopausal women with breast cancer (SOLE): a multicentre, open-label, randomised, phase 3 trial
In postmenopausal women with hormone receptor-positive breast cancer, extended use of intermittent letrozole did not improve disease-free survival compared with continuous use of letrozole. An alternative schedule of extended adjuvant endocrine therapy with letrozole, including intermittent administration, might be feasible and the results of the SOLE trial support the safety of temporary treatment breaks in selected patients who might require them.
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vrijdag 17 november 2017

BBC Health: Children join people with dementia in interactive light game

Children join people with dementia in interactive light game
The game sees images projected on to a table that residents and children can interact with.
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Boots 'breaking' morning-after pill promise, say Labour MPs
MPs urge the pharmacy to complete its roll-out of cheaper contraception across all of its stores.
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Autism concern over home schooling rise in Wales
Many autistic children are struggling to cope in schools and are being removed, a charity warns.
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Dog owners have lower mortality, study finds
Researchers found a lower risk of cardiovascular disease in owners of dogs, especially hunting breeds.
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Are grandparents spoiling kids?
A study says grandparents tend to give high-sugar snacks as treats - so we tracked some down.
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Sister starts blanket scheme to comfort end of life care patients

Sister starts blanket scheme to comfort end of life care patients
A Colchester ward sister is setting up a group of volunteers to make blankets for patients who are nearing the end of their lives and also to reduce loneliness among the knitters themselves.
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Study to test if new talking therapy can help cancer survivors cope
Researchers from leading UK universities and NHS trusts are to carry out a major new project to develop and test a talking-based therapy for cancer survivors.
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Trust turns to India and Philippines due to downturn in EU nurses
Oxfordshire University Hospitals NHS Foundation Trust is recruiting nurses from India and the Philippines in the light of a "marked reduction" in European Union staff coming to work in the UK.
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Hospital trust's nurses celebrate achieving pressure ulcer milestone
A department at Doncaster and Bassetlaw Teaching Hospitals NHS Trust that cares for older and vulnerable patients is celebrating an entire year without a severe hospital-acquired pressure ulcer.
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Warning over 'alarming' continuing drop in NHS health visitors
Health visitors have urged the government to reverse cuts to public health budgets, warning of a continuing "alarming" reduction in the number of NHS nurses working in 0-5-year-old services as a result.
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Community nursing leader receives CBE from Queen
A leading community nurse received her CBE from the Queen this week recognising both her services to the profession and her work as the head of the Queen's Nursing Institute.
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Nature Reviews Clinical Oncology - Table of Contents alert Volume 14 Issue 12

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2016 2-year Impact Factor 20.693 Journal Metrics 2-year Median 12
In this issue
Research Highlights
News and Views
Also this month
 Featured article:
The immune contexture in cancer prognosis and treatment
Wolf H. Fridman, Laurence Zitvogel, Catherine Sautès–Fridman & Guido Kroemer


npj Precision Oncology is a new open access, online-only, peer-reviewed journal committed to publishing cutting-edge scientific research in all aspects of precision oncology from basic science to translational applications, to clinical medicine.

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Comment: Evolution and cancer medicine — transformative insights
Erik Sahai & Charles Swanton

Published online: 22 August 2017
p709 | doi:10.1038/nrclinonc.2017.121

Few clinical trials incorporate studies of evolutionary cancer biology, despite the frequent emergence of acquired resistance to anticancer therapies. This problem motivated the first CRUK Marshall Symposium on Cancer Evolution in May 2017, which provided a forum for evolutionary and ecological theorists, cancer biologists, and clinicians to consider how evolutionary biology might inform improvements in cancer medicine. Herein, we discuss the key themes and opportunities for the future.
Full Text | PDF | Supplementary information


Immunotherapy: Nivolumab-induced alterations revealed
Published online: 08 November 2017
p711 | doi:10.1038/nrclinonc.2017.173


Immunotherapy: Gain beyond injection
Published online: 25 October 2017
p712 | doi:10.1038/nrclinonc.2017.172


Targeted therapies: Precision medicine for ATC — BRAF and MEK inhibition shows promise
Published online: 17 November 2017
p712 | doi:10.1038/nrclinonc.2017.181


Targeted therapy: ARIEL3 — broad benefit of PARP inhibitors in ovarian cancer
Published online: 10 October 2017
p713 | doi:10.1038/nrclinonc.2017.161


Haematological cancer: Extended EFS with rituximab
Published online: 17 October 2017
p714 | doi:10.1038/nrclinonc.2017.168


Breast Cancer: Abemaciclib effective in combination with aromatase inhibition
Published online: 17 October 2017
p714 | doi:10.1038/nrclinonc.2017.169


Skin cancer: Propranolol limits melanoma recurrence
Published online: 17 October 2017
p714 | doi:10.1038/nrclinonc.2017.170




Lung Cancer: Dacomitinib delays disease progression | Thyroid cancer: Cabozantinib effective in selected patients | Breast cancer: LAG3 expression indicates favourable outcomes | Lung Cancer: SABR effective against oligometastatic disease

Nature Reviews Clinical Oncology
JOBS of the week
Principal Scientist in Cellular Pharmacology
Johnson & Johnson
Research Scientist in Epidemiology
Alberta Health Services, Cancer Epidemiology
Funded Postdoctoral position in the Lecuit lab at Institut Pasteur
Institut Pasteur
MRC WIMM Prize PhD Studentships
Weatherall Institute of Molecular Medicine, University of Oxford
Institute of Metabolism and Diseases,Shanghai General Hospital
Shanghai General Hospital
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Nature Reviews Clinical Oncology
ECOP4 - European Conference of Oncology Pharmacy
Nantes, France
More science events from
Breast cancer: What lies beyond APHINITY for HER2-positive breast cancer?
Sasha E. Stanton & Nancy E. Davidson

Published online: 08 August 2017
p715 | doi:10.1038/nrclinonc.2017.125

Potential strategies for improving the outcomes of patients with early stage HER2-positive (HER2+) breast cancer have included dual anti-HER2 therapy. Recent results from the APHINITY trial show a statistically significant, but clinically modest, benefit from the addition of pertuzumab to trastuzumab and chemotherapy. Subsequent trials should focus on biomarkers to identify patients with HER2+ breast cancer who require more-intensive or less-intensive therapy.
Full Text | PDF

Nature Reviews Disease Primers — Stay updated 

Nature Reviews Disease Primers covers all medical specialties, already having published on more than 120 diseases and disorders since launching in 2015. With such a comprehensive article collection, our e-alerts are the perfect solution to stay updated on the latest content published by the journal. 

Register for the e-alert
The immune contexture in cancer prognosis and treatment
Wolf H. Fridman, Laurence Zitvogel, Catherine Sautès–Fridman & Guido Kroemer

Published online: 25 July 2017
p717 | doi:10.1038/nrclinonc.2017.101

Virtually all successful treatments of cancer either create, restore or enhance the antitumour immune response. Therefore, the specific features of the immune microenvironment, both before and after treatment, are important determinants of patients' outcomes. In this Review, the authors describe the influence of the immunological characteristics of the tumour microenvironment on responses to treatment in patients with a variety of cancers.
Abstract | Full Text | PDF | Supplementary information

Fusions in solid tumours: diagnostic strategies, targeted therapy, and acquired resistance
Alison M. Schram, Matthew T. Chang, Philip Jonsson & Alexander Drilon

Published online: 31 August 2017
p735 | doi:10.1038/nrclinonc.2017.127

A wide range of gene fusions have been detected in solid tumours, and the products of these fusions, some of which result in constitutive activation of kinase signalling, can be targeted using tyrosine-kinase inhibitors. However, the development of acquired resistance is almost inevitable. In this Review, the authors describe strategies used to diagnose and treat patients with fusion-positive cancers.
Abstract | Full Text | PDF | Supplementary information

Radiomics: the bridge between medical imaging and personalized medicine
Philippe Lambin et al.

Published online: 04 October 2017
p749 | doi:10.1038/nrclinonc.2017.141

Radiomics is the high-throughput mining of quantitative image features from standard-of-care medical imaging to enable data to be extracted and applied within clinical-decision support systems. The process of radiomics is described and its pitfalls, challenges, opportunities, and capacity to improve clinical decision making. The radiomics field requires standardized evaluation of scientific findings and their clinical relevance. This review provides guidance for investigations to meet this urgent need in the field of radiomics.
Abstract | Full Text | PDF | Supplementary information

Patient-reported outcomes in cancer care — hearing the patient voice at greater volume
Thomas W. LeBlanc & Amy P. Abernethy

Published online: 04 October 2017
p763 | doi:10.1038/nrclinonc.2017.153

In the past decade, the importance of patient-reported outcomes (PROs) as a key measure of the quality of care delivered to patients with cancer has been acknowledged. PROs were used in the context of research studies, but growing evidence indicates that the incorporation of electronic PRO (ePRO) assessments into standard health-care settings can improve the quality of care delivered to patients with cancer. The authors of this Review discuss aspects related to PROs such as measurements, implementation challenges, and outcome improvements associated with their use.
Abstract | Full Text | PDF

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Nature Reviews Clinical Oncology was previously published as Nature Clinical Practice Oncology.

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